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  • Karen McPhail, RN, MSN

Confusion in the elderly!

It always makes me a little upset when I hear people immediately jump to the conclusion of Dementia or Alzheimer's for an older individual when they start to experience some forgetfulness or some confusion. Not every elderly individual will suffer from Dementia or Alzheimer's. It's important to investigate some other areas before going down this path... First, forgetfulness does not indicate a cognitive problem. Believe it or not it is a normal aspect of aging to be a little bit forgetful as we get older. I always tell people something that my husband pointed out years ago ... remember that dementia is not forgetting where your keys are, it is forgetting what your keys are for. So, do not immediately worry if you have a family member or you yourself become slightly forgetful as you get older. Make some minor modifications, such as a reminders list and move forward! Second, confusion does not always indicate dementia. There are several factors that need to be evaluated and considered when looking at an individual with confusion. If this is something that is an acute onset situation, it could be due to several factors. First infection. Often times individuals become confused when they have an infection. A common issue in the elderly is urinary tract infections. They can lead to abrupt confusion and weakness and lead to sepsis if not treated. Always have your loved one seek prompt medical attention if abrupt confusion or a change in cognition is noticed. Call 911 if necessary! Nutrition and electrolyte balance can effect cognition. Often times as we grow older we tend to not eat as well or as well balanced. It's difficult to cook for one or to cook for two. Sometimes, we just can't make the same recipes or we just don't have the energy to do so anymore. As a result, electrolytes such as sodium, potassium, and magnesium and other nutritional elements go off balance. This is something to always consider prior to moving forward. Consult your physician and ensure that proper supplements are added, and that proper hydration and nutrition are always being maintained. Blood sugar levels often times can become a problem as we get older. Sometimes people slowly develop type two diabetes and do not even realize that it is occurring. The signs of blood sugar changes can be more subtle and often times missed except when blood work is done. For other people they have perhaps had type II diabetes for awhile and take for granted that their meds will work as they always have. As we grow older changes and modifications are needed from time to time in terms of our medications and treatment regimes. Sometimes people do not mind their nutrition as well as needed to accommodate changes. That being said, blood sugar related issues can result in extreme confusion. Check blood sugars consistently as advised and report any abnormal findings to your physician. Those with diabetes should always have emergency glucose gel (if able to take by mouth) or a glucagone emergency injection kit (for severe cases), accessible in the event of a low blood sugar episode (BS of 60 or less). Always consult a health care provider if experiencing low blood sugar episodes especially if glucagone was needed. And do not hesitate in calling 911 when in doubt, as it is better to be safe than sorry!

Finally, if you or a family member are experiencing frequent or consistent changes in cognition seek guidance from a health care professional. Talk with your physician and / or a Geriatric Care Manager who can assist in evaluating and providing input.

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